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1.This is based on both the existing research evidence showing liver cyst growth effects of estrogen and the clinical observation of more symptomatic, rapid liver cyst growth and  more frequent requirement of interventions associated with high-level estrogen exposure.
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2.. In view of its stimulatory effects on cell proliferation and  fluid secretion, a major approach has been to target cAMP production.
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3.Thus,autocrine/paracrine loops are established where these factors are secreted and accumulate within the cyst fluid ,bind to receptors and signal cell proliferation of the lining epithelium
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4. The role of vasopressin action in modifying cyst expansion in ADPKD has been given added weight by recent studies which indirectly suppressed (high fluid intake)  or enhanced its action (endothelin B receptor blockade)on the collecting duct.
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5.The protein products of these genes (hepatocystin  and  Sec63,  respectively)  act  in  concert  to achieve proper topology and folding of integral membrane  or  secreted  glycoproteins  in  the  endoplasmic reticulum (ER)
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6. One of the potential factors in promoting cyst growth is cAMP.Secretin, the major cAMP agonist in cholangiocytes, stimulates the targeting and insertion of several transporters and channels into  the  apical  membrane  of cholangiocytes.
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